Hepatic artery pseudoaneurysm is an uncommon and a late complication after a blunt hepatic trauma. Although hepatic artery pseudoaneurysms may stay silent, it is usually better to treat them due to the high hemorrhage risk they cause. We are presenting a patient with post traumatic hepatic laceration who had serious bleeding with late onset after percutaneous drainage of the old hematoma. On a multidetector computerised tomography (MDCT) scan, a large hematoma surrounding a pseudoaneurysm was diagnosed which was treated with endovascular cyanoacrylate (glue) embolisation.
Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma 1995 ;38:323-4. doi:http://dx.doi.org/10.1097/00005373199503000-00001
Malhotra AK, Fabian TC, Croce MA et al. Blunt hepatic injury: a paradigm shift from operative to nonoperative management in the 1 9 9 0 s . A n n S u rg 2 0 0 0 ; 2 3 1 : 8 0 4 – 1 3 . d o i : d x . d o i . org/1097/00000658-200006000-00004
Velmahos GC, Toutouzas K, Radin R, et al. High success with nonoperative management of blunt hepatic trauma: the liver is a sturdy organ. Arch Surg 2003;138:475–81. doi: dx.doi.org/10.1001/ archsurg.138.5.475
David Richardson J, Franklin GA, Lukan JK, et al. Evolution in the management of hepatic trauma: a 25-year perspective. Ann Surg 2000;232:324–30.dx.doi.org/10.1097/00000658-200009000-00004
Croce MA, Fabian TC, Spiers JP, Kudsk KA. Traumatic hepatic artery pseudoaneurysm with hemobilia. Am J Surg 1994;168:235–8. doi:dx. doi.org/10.1016/S0002-9610(05)80193-X
Yoon W, Jeong YY, Kim JK, et al. CT in blunt liver trauma. Radiographics 2005;25:87–104. doi: dx.do.org/10.1148/rg.251045079
Pachter HL, Knudson MM, Esrig B, et al. Status of nonoperative management of blunt hepatic injuries in 1995: a multicenter experience with 404 patients. J Trauma 1996;40:31–8. doi: dx.doi. org/1097/00005373-199601000-00007.
Dambrin C, Marcheix B, Birsan T, et al. Posttraumatic pseudoaneurysm of the hepatic artery: treatment with ultrasound-guided percutaneous transhepatic thrombin injection. J Trauma 2005;59:239–42. doi: http://dx.doi.org/10.1097/01.TA.0000171526.24911.B2
Paci E, Antico E, Candelari R, Alborino S, Marmorale C, Landi E. Pseudoaneurysm of the common hepatic artery: treatment with a stent-graft. Cardiovasc Intervent Radiol 2000;23:472–4.http://dx.doi. org/1007/s002700010107
Kim DJ, Willinsky RA, Krings T, Agid R, Terbrugge K. Intracranial dural arteriovenous shunts: transarterial glue embolization--experience in 115 consecutive patients. Radiology 2011 ;258:554-61. doi: http:// dx.doi.org/10.1148/radiol.10100755
Endovascular embolisation of a hepatic pseudoaneurysm causing massive hemorrhage after a blunt hepatic trauma
Year 2014,
Volume: 27 Issue: 1, 58 - 61, 30.09.2015
Hepatic artery pseudoaneurysm is an uncommon and a late complication after a blunt hepatic trauma. Although hepatic artery pseudoaneurysms may stay silent, it is usually better to treat them due to the high hemorrhage risk they cause. We are presenting a patient with post traumatic hepatic laceration who had serious bleeding with late onset after percutaneous drainage of the old hematoma. On a multidetector computerised tomography (MDCT) scan, a large hematoma surrounding a pseudoaneurysm was diagnosed which was treated with endovascular cyanoacrylate (glue) embolisation.
Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma 1995 ;38:323-4. doi:http://dx.doi.org/10.1097/00005373199503000-00001
Malhotra AK, Fabian TC, Croce MA et al. Blunt hepatic injury: a paradigm shift from operative to nonoperative management in the 1 9 9 0 s . A n n S u rg 2 0 0 0 ; 2 3 1 : 8 0 4 – 1 3 . d o i : d x . d o i . org/1097/00000658-200006000-00004
Velmahos GC, Toutouzas K, Radin R, et al. High success with nonoperative management of blunt hepatic trauma: the liver is a sturdy organ. Arch Surg 2003;138:475–81. doi: dx.doi.org/10.1001/ archsurg.138.5.475
David Richardson J, Franklin GA, Lukan JK, et al. Evolution in the management of hepatic trauma: a 25-year perspective. Ann Surg 2000;232:324–30.dx.doi.org/10.1097/00000658-200009000-00004
Croce MA, Fabian TC, Spiers JP, Kudsk KA. Traumatic hepatic artery pseudoaneurysm with hemobilia. Am J Surg 1994;168:235–8. doi:dx. doi.org/10.1016/S0002-9610(05)80193-X
Yoon W, Jeong YY, Kim JK, et al. CT in blunt liver trauma. Radiographics 2005;25:87–104. doi: dx.do.org/10.1148/rg.251045079
Pachter HL, Knudson MM, Esrig B, et al. Status of nonoperative management of blunt hepatic injuries in 1995: a multicenter experience with 404 patients. J Trauma 1996;40:31–8. doi: dx.doi. org/1097/00005373-199601000-00007.
Dambrin C, Marcheix B, Birsan T, et al. Posttraumatic pseudoaneurysm of the hepatic artery: treatment with ultrasound-guided percutaneous transhepatic thrombin injection. J Trauma 2005;59:239–42. doi: http://dx.doi.org/10.1097/01.TA.0000171526.24911.B2
Paci E, Antico E, Candelari R, Alborino S, Marmorale C, Landi E. Pseudoaneurysm of the common hepatic artery: treatment with a stent-graft. Cardiovasc Intervent Radiol 2000;23:472–4.http://dx.doi. org/1007/s002700010107
Kim DJ, Willinsky RA, Krings T, Agid R, Terbrugge K. Intracranial dural arteriovenous shunts: transarterial glue embolization--experience in 115 consecutive patients. Radiology 2011 ;258:554-61. doi: http:// dx.doi.org/10.1148/radiol.10100755